4 1/2 years I've been working at this now. 34 years with TOS and a failed surgery 23 years ago but I'm feeling the best that I've felt in many years. Improvements come very slowly after so many years and I've had a lot of setbacks but I keep at it. Patience and persistence are everything. Sometimes flare-ups can really slow down progress and set things back. I've learned not to be greedy and just be happy with whatever small improvements that I make.